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Prolonged use may increase insulin resistance | Low

372 In vitro, GLP-1 disrupts the ability of osteoblasts to survive and differentiate by triggering the activation of c-Fos, which is a proto-oncogene

When administered via subcutaneous injection, these medications bind to GLP-1 receptors in multiple tissues throughout the body, including the pancreas, brain, and gastrointestinal tract

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This finding is consistent with leading CKD treatment guidelines, where SGLT2is are recommended as first line in addition to RAS inhibition, metformin and statins [2, 7], and reflects the breadth of pivotal trial data (DAPA-CKD, EMPA-KIDNEY and CREDENCE) demonstrating earlier kidney and cardiovascular benefits (e.g